Bringing Advanced Therapies Home: Cardinal Health Report Sets the Stage for AXS26

As specialty pharmacy and pharmaceutical industry leaders prepare to convene for Asembia's AXS26 Summit in Las Vegas from April 26 to 30, one of the conversations generating early attention is the accelerating push to expand advanced therapies beyond the walls of academic medical centers and into community-based care settings. Cardinal Health has timed the release of its 2026 Advanced Therapies Report: Perspectives on Community Expansion to coincide with that conversation—and Fran Gregory, PharmD, MBA, vice president of emerging therapies at Cardinal Health, will bring its findings directly to AXS26 attendees in the session, "The Evolution of Advanced Therapies: How Specialty Pharmacies and Community Providers Are Improving Access to Patient Care."

The report could not arrive at a more consequential moment. There are currently 61 advanced therapies approved in the US, and Cardinal Health's pipeline analysis projects that number to nearly triple by 2030.¹

"When we talk about advanced therapies, we're thinking about not only cell and gene therapies but also innovative treatments like bispecific therapies, sophisticated monoclonal antibodies, and other treatments that are considered innovative and new to the market,” said Gregory in an interview with The American Journal of Managed Care^® (AJMC^®).

Sales of these therapies are expected to reach $80 billion by the end of the decade. Although oncology and hematology remain the dominant therapeutic areas, innovation is expanding rapidly into neurology, rheumatology, ophthalmology, cardiology, and rare diseases—broadening the universe of patients for whom an advanced therapy may one day be a treatment option.

"Some of those might include metabolic conditions or cardiovascular conditions—those are very, very large volumes of patients," said Gregory. "When we think about how academic medical centers are primarily responsible for administering advanced therapies today, the capacity to actually ensure patient access to these treatments moving forward really needs to expand."

Yet for most of those patients today, receiving such a therapy still means traveling to an inpatient academic or health system setting. The vast majority of cell and gene therapy treatment is currently administered at large academic medical centers in major metropolitan areas, leaving patients in smaller communities and rural areas with limited access to these transformative treatments. Research has found that the likelihood of receiving a chimeric antigen receptor (CAR) T-cell therapy was reduced by 40% when patients lived 2 to 4 hours from their nearest treatment center.² That same body of research found that 82% of oncologists surveyed agreed that expanding cell and gene therapies into community hospitals is necessary to ensure broader care access for patients, and 77% said care should also expand into community clinics.

"When we think about patients who have the means or the ability to travel to an academic medical center and to take off work and to be able to financially be comfortable with such a significant time out of their daily life, it certainly does raise some concerns around health equity," said Gregory. "If we can make these easier for patients to access, easier for them to logistically get to, then that's going to remove some of those barriers to care that some patients might experience more frequently than others."

The report draws on survey data from more than 160 physicians and administrators across community practices and health systems, supplemented by expert commentary and a patient case study illustrating the real-world impact of outpatient advanced therapy administration.¹ The findings reveal broad alignment between health systems and community providers on the value of this shift—and equally broad recognition that executing it is not simple.

Among health system respondents, nearly all either agreed (43%) or strongly agreed (54%) that partnerships between community practices and health systems are essential to achieving optimal patient outcomes. A similar share agreed (63%) or strongly agreed (33%) that moving advanced therapies into community settings would increase health system capacity to absorb the next generation of innovative treatments—a capacity argument with significant long-term implications as the pipeline grows.

But agreement on the destination does not flatten the road to get there. Nearly half of community practice respondents (48%) reported that preparing to administer advanced therapies took between 1 and 2 years, a figure that reflects the operational, clinical, and economic complexity of standing up these programs.³ Health systems cited investments in care coordination technology, while community practices pointed to the need to hire and train specialized staff and build entirely new clinical workflows. Across both settings, partnership models that include after-hours triage support, clinical training resources, and expedited referral pathways emerged as critical enablers of safe, scalable delivery.

On reimbursement—consistently among the top pain points in the space—Gregory pointed to several evolving mechanisms.

"Outcomes-based contracts have certainly become more common than they were 5 or 6 years ago," she said, describing agreements in which reimbursement is tied to whether a patient meets a clinical outcome milestone at a defined time point. Annuity plans represent another emerging model, notable in part for their potential portability when patients change insurers.

"Those annuity plans could potentially be portable—that's just a couple of examples of things that are still a little bit experimental but are definitely starting to be more prominent in the innovative therapy space," she said.

Underpinning both models, she argued, is a need for stronger real-world evidence on durability, as well as health economic models that help payers quantify value—including the cost offsets from avoided hospitalizations—before a therapy launches.

Gregory also made the case for specialty pharmacy as a structural enabler of the entire shift, describing its role in terms that went beyond logistics.

"I almost feel like the specialty pharmacy component is giving a physician's or provider's site a choice," she said.

Providers weighing whether to administer complex therapies face a formidable checklist—clinical complexity, nursing coverage, and triage protocols—and specialty pharmacy can absorb many of the surrounding administrative burdens: securing reimbursement, managing patient logistics, and supporting the long-term data collection that real-world evidence requires.

"Specialty pharmacies are really stepping into a sophisticated role and helping manage any complexity that they can kind of offload from the physician or the provider," said Gregory.

Cardinal Health is itself acting on that conviction, with a new specialty pharmacy slated to open May 13 as part of the company's commitment to improving patient access to complex therapies.

At AXS26, Gregory will be joined on the panel by Leigh Denny, PharmD, senior director of value and evidence scientific engagement, Johnson & Johnson, who will offer a manufacturer's perspective on collaborating with specialty pharmacies and community providers; and by Philip Marjon, MD, physician, California Cancer Associates for Research and Excellence, who will discuss the on-the-ground challenges and opportunities of delivering advanced therapies in practice.

References

1. 2026 Advanced Therapies Report: Perspectives on Community Expansion. Cardinal Health. April 14, 2026. Accessed April 16, 2026. https://www.cardinalhealth.com/en/services/manufacturer/biopharmaceutical/cell-and-gene-therapies/advanced-therapies-report.html

2. DePinto J. Cell and gene therapies hold promise, but access barriers persist. Am J Manag Care. 2024;30(Spec. No. 15):SP1184. Accessed April 16, 2026. https://www.ajmc.com/view/cell-and-gene-therapies-hold-promise-but-access-barriers-persist

3. Caffrey M. Community practices work to expand access to cell and gene therapies. AJMC. September 9, 2025. Accessed April 16, 2026. https://www.ajmc.com/view/community-practices-work-to-expand-access-to-cell-and-gene-therapies